By Danielle Fryer, RD, CSSD, CSCS
If you want to maximize your lean body mass composition, you need to strength train, eat to build muscle, practice stress management, and get seven to nine hours of sleep each night. Additionally, creatine monohydrate can boost your results beyond athletic performance! Furthermore, new research suggests that creatine is beneficial in individuals whose cognitive processes are stressed, sleep deprived, suffering from oxygen deprivation at the tissue level (hypoxia), or during cognitively demanding tasks. 
What is creatine?
Creatine is a naturally synthesized in the body. A diet that includes animal sources, such as meat, fish, and poultry, along with synthesized creatine from your liver, kidneys, and pancreas, amount to about 1g. of creatine per day. Vegetarian athletes that strength train have lower resting creatine concentrations and may especially benefit from creatine monohydrate supplementation. Creatine helps to regenerate a molecule called adenosine triphosphate (ATP), your body’s main source of energy. When creatine stores in your muscles are depleted, the production of ATP comes to a halt and your energy is decreased. Creatine is stored in skeletal muscle, brain, liver, kidney, and testes.
What is creatine monohydrate?
Creatine monohydrate is one of the few, well-researched supplements on the market. Creatine Monohydrate has a positive relationship between muscle uptake and exercise performance.
Research shows that the positive effects are for strength, power, fat free mass, daily living performance, recovery, and neurological function in adults and children that are post puberty. It is proven to increase muscular power and strength, predominately through anaerobic, intermittent exercises, speed training and endurance training too.  By being able to enhance your performance load and endurance strength (i.e. getting one or two more repetitions in a set), your lean mass will grow stronger and larger (hypertrophy). Effects of creatine monohydrate diminish as the length of time spent exercising increases. Creatine supplementation aids best with quick bursts of power and strength, but other studied benefits include improvement of fatigue, and bone mineral density. Additionally, science has shown that creatine supplementation increases cerebral phosphoryl creatine which reduces metabolic demand and enhances neural activity in the brain. 
Not all people respond to creatine supplementation. There is such a thing as a “non- responder.” A non-responder would be an individual who has higher total creatine content, and possibly less type II fibers in their body. Because they do not respond to creatine supplementation, they should discontinue taking the supplement if no improved performance is measurable.
How much do I need to take?
Before you do the necessary math below, convert your bodyweight into kilograms. (Divide your weight in pounds, by 2.2) In order to saturate creatine stores in the muscle, a loading phase is required. A typical creatine supplement loading phase is 20 to 25 grams or 0.3 grams per kilogram of bodyweight, per day (0.3 g/kg/d) split into 4 or 5 daily intakes. However, a moderate loading protocol that provides a more efficient saturation is dosing your total intakes of 1g. each, every 30 minutes, for the total grams needed per day. The loading phase must be followed by a maintenance period of 0.03 to 0.1 grams per kilogram of bodyweight, per day (0.03-0.1 g/kg/d) for the entirely of its use. A 25 percent greater creatine retention is promoted when combining creatine monohydrate with simultaneous ingestion of protein and carbohydrates. I recommend adding it to your post workout shake that is comprised of 20-30 grams of whey protein isolate, 8 ounces of skim milk, a serving of fruit, and a large handful of raw spinach. NOTE: If you aren’t eating enough daily carbs or protein, muscle gains with or without supplementation will be significantly less.
If you stop taking creatine your muscles will slowly drop down to their normal creatine levels. It will take approximately four to five weeks for this to happen. With or without creatine monohydrate supplementation it’s a good idea to keep up a healthy exercise regimen that suits your lifestyle and needs.
What are the side effects?
There is some concern that it could harm the kidney, liver, or heart function. However, a connection between high doses and these negative effects have never been proven. Creatine may cause stomach pain, nausea, diarrhea, and muscle cramping in some people. Some people experience a little water weight gain, but the net positives of creatine supplementation seems worth it to most. The weight is strictly water weight, as creatine causes muscles to draw water from the rest of your body. If you take creatine monohydrate be sure to drink plenty of water. Oral supplementation is considered safe and ethical, but the perception of safety cannot be guaranteed especially when administered for long period of time to different populations.
References: Dolan E, Gualano B, Rawson ES. Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. Eur J Sport Sci. 2018 Aug 7:1-14 doi: 10.1080/17461391.2018.1500644  Robert Cooper, Fernando Naclerio, Judith Allgrove and Alfonso Jimenez. Journal of the International Society of Sports Nutrition 20129:33. © Cooper et al.; licensee BioMed Central Ltd. 2012
Danielle Fryer RD, CSSD, CSCS is an advocate for healthy living. Fryer is a registered dietitian nutritionist, board certified specialist in sports dietetics, certified strength and conditioning specialist and yoga teacher. She has served in fitness and nutrition leadership roles in Pennsylvania, New Jersey, Alabama, and Arizona. She now lives in Scottsdale and works as the new Director of Health & Fitness at The Country Club at DC Ranch.